The battle against mosquito-borne illnesses took on a sense of urgency when 264 Big Island residents were infected with dengue fever during a half-year outbreak that wasn’t quelled until last April.

And the threat of the Zika virus that can be carried by some of the same mosquitoes has done nothing to diminish ongoing concerns.

But 20 positions funded by the Legislature last spring to better track, trap and kill mosquitoes have yet to be filled — or even advertised.

DOH Environmental Health Specialist Geoffrey Lau applies larvacide to standing water in bromelliads with Stanley Yu at the King Kamehameha Hotel. Kailua Kona Hawaii. Dengue prevention.
On Hawaii Island, DOH Environmental Health Specialist Geoffrey Lau applies larvicide to standing water – a haven for mosquito eggs – at the King Kamehameha Hotel during the dengue fever outbreak. Cory Lum/Civil Beat

The additions represent the biggest funding  for the Department of Health’s Vector Control Branch since significant budget cuts were made on the heels of a national recession.

Vector Control employees conduct site inspections to look for mosquitoes and their eggs, which are found in standing water. A lab assistant and entomologists — scientists who study insects — were also on the list of positions the Legislature funded.

Keith Kawaoka, DOH deputy director of environmental services, told lawmakers during a hearing last week that none of those positions had been filled because of administrative issues such as old job descriptions that need revision, but he hoped to have them filled by the end of the year.

“Knowing what is happening now, we really do need to fill the positions much quicker.” — Sen. Suzanne Chun Oakland

Sen. Suzanne Chun Oakland, who sponsored dengue-related bills last session, pressed Kawaoka during the hearing about the delays.

Chun Oakland told Civil Beat that she spoke with Kawaoka after the hearing and was told DOH is doing its best to speed up the hiring process, but anticipated difficulty filling four entomologist positions.

The senator said she contacted the University of Hawaii Manoa’s College of Tropical Agriculture and Human Resources to get the word out about the openings. Qualified people are out there, she said, but “we just need to ask.”

Getting the Department of Health fully staffed is important not only to address mosquito-borne illnessses, but also but also to conduct restaurant inspections amid a hepatitis A outbreak on Oahu, she said.

“Knowing what is happening now, we really do need to fill the positions much quicker,” Chun Oakland said.

Kawaoka was with the DOH 15 years before taking his current position in 2015.
Keith Kawaoka, DOH deputy director of environmental services, said the department hopes to fill the new positions by the end of the year. Cory Lum/Civil Beat

In 2013, the DOH got funding to add four Vector Control employees to monitor Oahu entry points like the Honolulu International Airport. Those positions weren’t filled until 2015, according to the Vector Control home page.

Funding for another four positions became available in 2015, and those were filled from February to June of this year, the DOH said.

‘Critical Deficiencies’

Hawaii is a home of Aedes aegypti, a mosquito that transmits infections such as Zika and dengue fever. It has only been found on the Big Island so far.

Mosquito-borne illness didn’t seem like as much of a threat in 2010 when legislators agreed to Gov. Linda Lingle’s request to eliminate 18 Vector Control positions.

Fast-forward to last October, the onset of the dengue fever outbreak. At that point the state had 25 Vector Control positions, but eight were vacant.

When officials from the Centers for Disease Control and Prevention paid Hawaii a visit in January, they found “critical deficiencies” at the state Department of Health, mostly stemming from its staffing shortage.

“If Sen. Chun Oakland knows a faster way to get through state processes, awesome. And I’m sure Keith Kawaoko and (DOH Director Virginia) Pressler feel the same way.” — State Epidemiologist Sarah Park

Kawaoka said in an interview that following the national economic downturn of 2008-2009, Vector Control’s staff lost about 25 positions.

More than 100 employees were laid off throughout DOH, department spokeswoman Janice Okubo said.

When the dengue outbreak hit, Kawaoka said the Vector Control Branch scrambled for additional manpower, equipment and pesticides on an emergency basis.

The emergency hires still work for the branch. Now there are roughly 30 Vector Control employees and the DOH has the authority to employ around 55, he said.

Last legislative session, DOH requested money to hire 31 more Vector Control workers, but only got enough for 20. If those positions can be filled this year, Kaawaoka said he plans to ask for 11 more positions next year.

The Aedes aegypti is one of two mosquitos in Hawaii capable of transmitting Dengue.
The Aedes aegypti is one of two mosquitos in Hawaii capable of transmitting Dengue. Graham Snodgrass / Courtesy of Army Medical

Regulations make government hiring more difficult than in the private sector, Kawaoka said. It’s also harder to get rid of unsatisfactory government workers, he said.

“You can’t just get anyone on the street,” he said.

The islands have unique differences, too, that need to be accounted for when determining what work will be done, Kawaoka said.

Although many DOH employees – from management to human resources – are involved to some extent in the hiring process, Kawaoka estimated about 12 to 15 workers are directly working to prepare for the new hires.

“Everybody recognizes there’s an urgent need to have these positions established and filled,” he said, adding that in the interest of expediency, DOH is simultaneously recruiting and completing organizational tasks.

The DOH is actually going through this hiring process “fairly fast” compared to less urgent hires, he said.

One person DOH has identified as a candidate lives on the Big Island and was part of the recession layoffs, Kawaoka said.

State Epidemiologist Sarah Park, who’s spearheading the fight against hepatitis A, said she recognized Vector Control needs “to be rebuilt.”

“If Sen. Chun Oakland knows a faster way to get through state processes, awesome,” Park said. “And I’m sure Keith Kawaoko and (DOH Director Virginia) Pressler feel the same way.”

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